TX HHS Form 3681-A. Community Services Contract Application - Addendum A

The TX HHS Form 3681-A. Community Services Contract Application - Addendum A is a crucial document for entities operating assisted living facilities in Texas. This form helps solve the problem of ensuring compliance with state regulations and facilitates the contracting process between facility operators and the Texas Health and Human Services (HHS) agency.

This addendum provides additional information required to complete the community services contract application. Key features include the entity's legal name, doing business as (DBA), if applicable, and physical address. The form also collects data on the size of the assisted living facility, licensed capacity, and type of license held. Additionally, it requires calculation of private space square footage per resident, which is essential for meeting HHS standards.

The TX HHS Form 3681-A. Community Services Contract Application - Addendum A is typically used by entities operating assisted living facilities in Texas that need to contract with the state agency. This form helps ensure compliance with state regulations and facilitates the contracting process. Key points to note include:

• Entities must provide their legal name, DBA (if applicable), and physical address.
• The size of the assisted living facility, licensed capacity, and type of license held are required.
• A calculation of private space square footage per resident is necessary for compliance with HHS standards.